Insurance Status and the Use of the Emergency Department for Minor Dental Problems

Abstract

CONTEXT: Emergency departments (EDs) are costly yet a fundamental part of the health care continuum. Unfortunately, many people use the ED for ailments that could be best treated at other points of care. While, through billing codes, we cannot determine who is using the ED inappropriately and who is not, we can investigate conditions that should never be treated in the ED. One prevalent example of this is people who visit the ED for minor dental complaints. Roughly one percent of ED visits are for toothaches according to nationally representative data.

METHODS: After summarizing relevant literature, this study methods similar to a study published in the Annals of Emergency Medicine. This study uses data from the Centers for Disease Control National Hospital Ambulatory Medical Care Survey (NHACMS) data from 2006-2010 to examine payment and demographic trends across groups who visit the ED for toothache treatment. I chose a linear probability model (LPM) to evaluate how payment method, age, gender, race, income and geography affect the likelihood of a person using the ED for minor tooth complaints.

FINDINGS: Analysis reveals that those with Medicaid or no insurance are much more likely to use the ED for toothaches compared to those with private insurance. Whites and those between the ages of 18 and 35 were much more likely than other groups to seek care in the ED for tooth complaints.

CONCLUSIONS: Policy makers should consider expanding dental coverage to those with Medicaid. It is clear that dental insurance and increased access to preventative services reduces dental ED visits but its unclear what the exact policy lever may be. Education, income, access to a dental provider, and insurance all should be considered when looking for policy mechanisms to reduce unnecessary visits to the ED for dental concerns.